Childhood Illnesses
Symptoms of conjunctivitis
purulent drainage, crusted shut, erythema, edema, pruritus, tearing
s/s of ringworm
red circular rash with clear middle, scaly, itchy, hair loss *treat with antifungal
Parents are concerned because their 18-month-old will eat only when they feed him. They report he was independent with feeding at home but is unwilling in the hospital. The nurse considers this behavior:
regression
Recurrent infections with otitis externa could cause
risk of hearing loss-treat with anti fungal ear-drops
Treatment of pertussis
secretion control: suction, oral humidity, fluids, droplet precaution, high fowlers position *D-tap vaccine
Manifestations of imeptigo?
skin papules-progress to vesicles, then painless pustules with narrow red border, honey-colored crusting (soak before removing and apply antibiotic)
How does hookworm enter the body?
soil, enters thru pores in hair or hands/feet
Encopresis
soiling underwear beyond expect age of 4-5, can cause stretched rectum
Major complications of mono
splenic rupture, guillan-barre syndrome, aseptic meningitis (lumbar puncture=negative)
Treatment for influenza
supportive care-hydration, vaccinations
treatment for covid-19
symptom relief: hydration, rest, pain/fever meds, quarantine, isolation
Viral treatment of tonsillits
symptomatic: popsicle, fluids, tonsillectomy for recurrent infections
types of play
therapeutic: non-directed, helps child w/ fears emotional outlet: acts out real-life stressors enhance cooperation: playing during unpleasant therapy *blow pinwheel to deep breath teaching: use hospital equipt. to teach unstructured: child controls events, ideas, relationships
T/F: RSV is common in toddler but deadly for infants
true *use supportive care and suction
Constipation is common/uncommon in children?
very common, 30% of pop. during toilet training due to painful experience
Erythema infectiousm- 5th disease spreads by
viral: droplets, blood, mother-->fetus (no longer infectious when rash appears)
3 types of conjunctivitis
-allergic: antihistamine eye drops -infectious: very contagious-throw away wash cloths, makeup, contacts -chemical
symptoms and treatment for otitis externa
-hsx of pain, itching, drainage -very painful! use warm compress, analgesics, earplugs, no cotton swabs/headphones
what is meningitis and what are the 3 types?
-inflamm of brain and spinal cord-spread thru droplets -viral, fungal, bacterial (most common and fatal)
interventions for croup
-listen for inspiratory stridor and suprasternal reactions -monitor spo2 -have child be quiet and sit up -use humidified air and corticosteroids
symptoms of Covid-19
50% asymptomatic, cold/flu, cough, fever, loss of taste and smell
What is croups main sign?
Barking cough
Symptoms of RSV
Begins with URI, runny nose, cough, sneezing, fever, wheezing
How do you obtain RSV?
Direct contact with secretions or object
Major complication of Pertussis
Pneumonia (treat with anitbiotics)
What is the leading cause of resp. illness in ages <2?
RSV
What is the best method for the nurse to reduce the pain of an IM injection for a child?
Request an anesthetic cream to apply before injection.
What is a major complication of tonsillitis
Scarlet fever
A woman brings her daughter to the pediatric clinic because she is concerned that the child has otitis media. On examination, the nurse would recognize which of the following findings as the most common positive sign of otitis media?
Temperature of 39 degrees C and loss of appetite
Symptoms of Tonsillitis
fever, chills, sweats, hoarse voice, swollen lymph nodes, white spots, swallowing difficulties= decreased appetite or difficulty breathing
treatment for mono
saltwater gurgles, rest (fatigue up to 6 weeks)
The nurse encourages parents of hospitalized infants and toddlers to stay with their child to help decrease what potential problem?
seperation anxiety
S/S of crypto
severe watery diarrhea, n/v, ab pain, fever, wt loss -diagnosed with stool sample, self-limit: hydration
s/s rotavirus
shed in stool, severe watery, crampy diarrhea=DEHYDRATION!
The nurse is preparing to start an intravenous (IV) line on a stable pediatric client in the hospital. Which location is most appropriate for the nurse to use for this procedure?
the pediatric treatment room
Bacterial or viral: tonsillitis and strep throat
tonsillitis=viral/bacterial strep throat=bacterial
How is rotavirus spread?
viral: fecal-oral, oral vaccine targets 5 diff strains
symptoms of 5th disease
fever, headache, URI, flushing, slapped cheek-spreads to trunk, lace-like rash -supportive care: itching and pain, resolves on own
symptoms of meningitis
fever, headache, fatigue, light sensitivity, stiff neck
Symptoms of mono
fever, malaise, sore throat, lymphadenopathy
How is ringworm spread?
fungal: human-human, human-animal, soil, objects
symptoms of hand foot and mouth disease
high fever-1st, oral ulcers, vesicles on hands and feet (football shaped with red rims), anorexia, dehydration, drooling
what is Acute otitis media? how is it spread?
infection of middle ear, bacterial/viral *bacterial=antibiotics, viral= resolves on own
Otitis externa is? what is it caused by?
infection of skin of external ear canal, caused by swimming
What is the leading cause of death during the toddler period?
injuries
scabies s/s and treatment
intense pruritis (@ night), erythematous, papular rash with exhortations -treat with scabicide-apply to entire body, clean house and bedding *itching may not subside for weeks
Detachment stage of seperation
interested in environment, may develop other attachments and ignore parents.
Head lice symptoms
itchy scalp, scratching marks/small leisons, can be asymptomatic
how to help skin disease with children?
keep nails short! -prevents scratching of rashes -keeps bacterial out
Mononucleosis is know as
kissing disease -transmitted through saliva
how do you pull an ear of a child younger than 3 vs greater than 3?
less than 3= ear down and back greater than 3= up and back
At what age is febrile seizure common?
less than 5, usually benign, related to viral illness or underlying condition
If a child is in a play room it is okay to bring their vaccine in and administer?
no- seen as a safe space
A 2-year-old boy is scheduled to undergo an endoscopic procedure. His parents are asking when they should tell him about it. Based on the nurse's understanding of the child's developmental stage, when would be the most appropriate time to prepare the child for the procedure?
A few days in advance of the scheduled date
A school-age client is in the clinic for a sprained ankle and is prescribed to take a nonsteroidal anti-inflammatory drug (NSAID) for pain control. What should the nurse inform the parent may be associated with long-term administration of any NSAID?
Severe gastric irritation
How does influenza spread?
droplets *viral (common in winter)
How to help with constipation
encourage fluids, fiber, fruits and veggies, toilet schedule, behavior modification, laxatives
T/F: a family of a child with scabies, should not be precautions
false- family precautions as well
T/F: URIs are usually secondary bacterial infections of ear, throat, sinuses, and lungs
True
When determining the correct therapeutic dose of most medications for children, what is the most important assessment to make?
Weight
How is pinworm spread?
fecal-oral, toys, bedding, toilet----diagnosed visually (out at night)
Where is meningitis common?
close quarters: college dorm-vaccine
T/F: hand-foot-mouth is cured by antibiotics
false- typically self limiting and resolves in 1 week
When a child is hospitalized and must be away from the caregiver, the child goes through stages of response to the separation. The child who cries and refuses to let the nurse or anyone else provide comfort and is continually looking out the door to see if the caregiver is returning is in which stage of separation?
protest
An 8-month-old infant was admitted to the hospital with severe diarrhea and dehydration. Fluid replacement therapy was initiated. Which observation the nurse makes indicates an improvement in the infant's status?
Infant has gained 3 oz. since yesterday
how does Pertussis (whooping cough) spread?
bacterial via droplets (starts with 7-10 days of cold symptoms, cough can last 1-4 weeks)
Two hours after a child with acute laryngitis (croup) is admitted, the nurse observes an increase in the child's respiratory and cardiac rates, increased restlessness, and substernal and intercostals retractions. The nurse, acting on these observations, should immediately:
Inform the physician of the child's respiratory status
Hand-foot-mouth disease spreads by
contact with infected fecal or oral
The nurse is assessing a 6-month-old infant during a well-child visit. The nurse makes all of the following observations. Which of the following assessments made by the nurse is an area of concern indicating a need for further evaluation?
Moderate head lag when pulled to sitting position
how is impetigo spread?
contagious bacterial infection of skin-follows skin trauma
Most common cause of cryptosporidium
contaminated water (parasitic)
Pertussis symptoms
cough sounds like "whoop", copious secretions, congestion, fever, fatigue. Violent cough, very exhausting can lead to vomiting and cyanosis (may crack ribs)
symptoms of influenza
cough, fever, body aches, sore throat, chills, headache
The nurse is caring for a child who has been hospitalized for 6 days and whose caregivers are unable to stay with the child. The child cried most of the day for the first 3 days but now is quiet and withdrawn. This behavior in the child is an example of which stage of separation?
despair
The community health nurse is making a newborn follow-up home visit. During the visit the 2-year-old sibling has a temper tantrum. The parent asks the nurse for guidance in dealing with the toddler's temper tantrums. Which of the following is the most appropriate nursing action?
Suggest that the parent ignore the child's behavior
A school nurse is preparing a talk on safety issues for parents of school-aged children to present at a parent-teacher meeting. Which topics should the nurse include based on the age of the children? Select all that apply.
Teaching pedestrian safety, Providing swimming lessons and water safety rules, Teaching child how to "stop, drop, and roll"
treatment of hookworm
diagnose with stool sample, treat with anti-parasitic and iron supp.
acute otitis media symptoms
ear pain, fever, irritable, crying when laying down, drainage *breastfed= lower incidence
The nurse is caring for a school-age child with cerebral palsy. Which of the following developmental tasks may be delayed at this age?
achieving good grades in school
considerations of febrile seizure
associated with a rapid rise in body temp-usually no long term affects, pad side rails, determine cause of fever and control.
symptoms of pinworm
asymptomatic, anal itching, restless, wt loss, involuntary urination at night -treat with anti-parasitic single dose-repeat 2 weeks later, shower in morning, short nails
Symptoms of hookworm
asymptomatic, rash at entry site -can cause anemia (worms suck blood), hypoproteinemia, edema, pica, wasting, physical disabilites
Croup is most common during the day/at night
at night (can become serious ad cause resp. distress)
How to care for someone with URI
avoid close contact, rest *symptom relief: humidity, fluids, nasal spray *no antibiotics for viral
what is a major sign of a foreign body?
bad breath (caused by infection in area) -treat by non-invasive or surgical removal
In which of the following phases of child hospital care would the nurse use the child's favorite toys to establish rapport?
building a trusting relationship
How does croup affect the body?
causes inflammation and edema in airways causing the airways and trachea to narrow
Protest stage of seperation
child cries, resist attention of staff, act out (healthy)
Despair stage of seperation
child withdraws, quiet, doesn't care what's done to them
URI/common cold is spread by
person-to-person air
Major complication of bacterial influenza
pneumonia
How is scabies spread?
prolonged close personal contact (contact precautions), mites seen on microscopic skin exam-dont survive 3-4 days without contact